Individual
DR. KERI RENHUI WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 CHILDRENS PL STE 2130, SAINT LOUIS, MO 63110-1002
(314) 454-6120
(314) 454-4225
Mailing address
1 CHILDRENS PL STE 3S34, SAINT LOUIS, MO 63110-1002
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2021019874
MO
2084N0400X
Neurology Physician
2021019874
MO
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
2021019874
MO
390200000X
Student in an Organized Health Care Education/Training Program
2021019874
MO
Other
Enumeration date
06/09/2021
Last updated
07/29/2025
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